Alabama's prison suicide rate lower than national average

An inmate on suicide watch in the stabilization unit of the Bullock Correctional Facility paces in his cell. Inmates on suicide watch are given a blue tunic to wear and a safety blanket, both made from material that can't be torn. (The Birmingham News / Tamika Moore)UNION SPRINGS -- The Alabama prison system has plenty of well-publicized problems -- not enough money, not enough correctional officers, not enough space, to name a few -- but officials say inmate suicide is not one of them.

During fiscal 2009, when the system housed more than 25,000 prisoners, one took his own life and four made unsuccessful attempts. Two committed suicide the year before. So far during the current fiscal year, the system has had no suicides and 11 attempts.

Dr. Ron Cavanaugh, a clinical psychologist who oversees mental health treatment in the prison system, said that nationally, the annual state prison suicide rate is about 16 per 100,000. Alabama's inmate suicide rate has been about four per 100,000 -- about one per year.

No one factor explains the state's low prison suicide rate, but Department of Corrections officials say it is due in large part to a program they put in place after the state reached a settlement of a longstanding mental health care lawsuit known as the Bradley case in 2000.

"We have really responded to the challenge," said Lt. Lloyd Hicks, who works in the 282-bed mental health unit at Bullock Correctional Facility, one of three mental health units in the state system.

Capt. Henry Perkins, the unit's day-shift supervisor and a 28-year prison system veteran, said that before Bradley, inmates who attempted to harm themselves were put under watch in restricted settings and had potentially harmful objects taken from them, but the procedures were not part of an intensive program like the one the system has now.

"We took our policies and procedures that had to do with mental health and actually turned them into administrative regulations," Cavanaugh said. "So that way, we could standardize procedures, services and treatments, interventions, all across the system."

Charles Woodley, chief psychologist for MHM Services, a private mental health contractor that staffs much of the prison system's mental health program, says the system takes "a very conservative approach in dealing with inmates who are suicidal.

"If an inmate declares themselves to be suicidal, we are going to provide the care that is necessary," Woodley said. "We understand that individuals ... have various degrees of distress and varying commitments to carrying out the suicidal act, but our commitment is to address whatever it is they are presenting."

This year, Corrections has nearly $13 million in its mental health budget and about 135 mental health employees, most of them hired through MHM Services. They range from psychiatrists and psychologists to counselors, therapists, nurses and support staff.

While the numbers of mental health employees and dollars are a little lower this year because of budget constraints, Cavanaugh said they dwarf the resources the prison system had before the Bradley settlement.

"What you had then was a couple of psychiatrists and a couple of psychologists contractually and some part time, and you've gone from maybe half a million dollars to $12-$14 million," he said. "You're actually funding a service where before you weren't."

The mental health unit at Bullock, a stand-alone building at the back of the prison complex that began operating in fiscal 2005, is one of two facilities with a cellblock where the system's suicidal male inmates are sent for intensive treatment and put under round-the-clock watch. Tutwiler Prison for Women has a unit of its own.

Every major prison in the system has two safe cells to house inmates who are at risk for suicide. If they do not respond to treatment at the prison that houses them, they will go to Bullock or to the mental health unit at Donaldson Correctional Facility, in west Jefferson County.

While most of the inmates in the Bullock mental health unit receive treatment while living in dormitories and wear standard-issue prison whites, those under a suicide watch are housed in safe cells in a two-tiered separate "SU" or stabilization unit.

While in the safe cells, inmates wear blue smocks and sleep under blue blankets, both designed so that they cannot be used to inflict harm. The prisoners are not allowed even to keep a toothbrush, and any letters they might get are not stapled to the envelopes because staples can become cutting tools. Each safe cell has no electrical outlets, the overhead light fixture is covered and the mattress on which the inmates sleep is just a few inches off the floor.

Last week, two inmates were in two safe cells in the lower tier of the SU's battleship-gray cellblock. They had virtually no privacy, since officers on round-the-clock floor duty, as well as one in a glass-enclosed cubicle just inside the entrance to the unit, could see them through the glass upper half of their cell doors.

One of the inmates, wearing his blue smock, paced and came to his door from time to time to gaze out. Another, wearing his blue blanket around his waist, stood at his cell door and hollered as Officer J.B. King stood on the landing above and watched.

King said inmates don't hurt themselves in SU, but they come there after they have hurt themselves in less restrictive settings.

"They'll try anything," King said. "The one that really got me was when the guy bit off his fingernails and slit his wrists."

King has spent more hours than he can count with inmates who have hurt themselves, and he has heard a myriad of explanations as to why they did it.

Some have said voices told them to do it, he said. Others have had "problems at home they can't handle because they're locked up" or can't handle the realization that they have 30 years to serve before they get out. Others may not want to die, he added, but do enough damage to themselves so they will be moved to SU and away from someone with whom they are having problems, a common one being monetary debt.

That's why, when he hears someone talking the suicide talk, King's first response is, "How much do you owe?"

Cavanaugh said correctional officers are trained to deal with inmates prone to self-harm or suicide, and part of their job is to take any warning sign seriously, even if they don't think the inmate will go through with the ultimate act.

Late last week, in a less restrictive part of the Bullock mental health unit, an inmate who had spent some time in one of SU's safe cells spoke in a frail voice about trying to strangle himself. It was not about money, he said, but about such things as the loss of contact with his children, a feeling that he had wasted his life and did not have any purpose. His time in SU brought him sessions with a psychiatrist, counselors and nurses, and bouts of group therapy.

The man, whose name was withheld under a prison privacy policy, said he was 51, was doing time for sodomy and sexual abuse, and was not due for release until 2020.

Asked whether he could make it until then, he said, "I'm working on it. I've got a different direction for my life than I had before."